In its continuous efforts advocating for the IBCLC®, NLCA has issued this position paper on licensure. NLCA considers licensure of the International Board Certified Lactation Consultant integral to the provision of clinical lactation care to childbearing families. Licensure of qualified IBCLCs® facilitates clinical lactation care that is safe, affordable, risk appropriate, and equitable. The position paper explores the need for licensure, the benefits, the challenges, and includes 27 references. Advocates can use this document in their work advancing the IBCLC® profession, in securing reimbursement for clinical lactation care services, in efforts to improve families’ access to clinical lactation care, and to enhance access to the profession.

At the National Lactation Consultant Alliance, we are looking to the future – a future in which breastfeeding families can readily access safe, clinical lactation care and in which Lactation Consultants are paid equitable compensation for their professional care.  To achieve these goals, NLCA works for the licensure of Lactation Consultants in every state in the US.

Licensure is an access opportunity—an opportunity for Lactation Consultants to engage in a profession, be recognized as a member of the healthcare team, and be appropriately reimbursed for their clinical lactation care. Licensure represents an access opportunity for those under-resourced breastfeeding families to receive the clinical lactation care they need, to enjoy the
same enhanced maternal/infant health outcomes as high resource families, and to experience a lower risk of maternal/infant morbidity and mortality.

We each play a role in achieving this vision by advocating for the value of the clinical lactation care that Lactation Consultants provide to families. Join us!

What is licensure?

Licensure of healthcare professionals, such as Lactation Consultants, occurs at the state level.

Licensure is the means by which a state legislature sets the minimum standards of education and training for individuals to engage in the “scope of practice” that legislatures set for particular healthcare profession. The state then issues easily identifiable licenses to qualified persons to ensure public protection. Licensure further protects citizens by providing an avenue for the individual consumer to challenge the competency of a licensed individual. A matter of constitutional law, states may not license occupations or professions unless they determine that licensure is reasonably necessary to protect the health, safety and welfare of its citizens.

Why is licensure important?

Licensure is important for many reasons, but public safety is its pre-eminent purpose. A secondary reason licensure is important is that it improves access to care for those breastfeeding families who seek care through Medicaid or Champus/Tricare (in many states, this is 50% or more of all birthing families). Unless a specific exception has been granted by the Centers for Medicare & Medicaid Services (CMS), Medicaid and Champus/Tricare can only reimburse the clinical care of licensed healthcare providers. Put simply, to join a Medicaid participating provider panel, one must be licensed by the state to perform clinical care within a scope of practice. Therefore, licensure of Lactation Consultants is the first step in remedying the inequitable access to clinical lactation care between those who have private insurance and those under-resourced families who seek care through Medicaid.

Want to get Involved?

At NLCA, we offer the education and grassroots advocacy tools you need to succeed in your state.  We know that legislative advocacy is new, and perhaps even a bit intimidating, for most Lactation Consultants. We are here to help YOU!

Your first step is to join our state advocacy committee:  please contact us here.

Your second step is to collect Testimonies to Support Licensure:

When state officials consider a licensing bill, they wish to understand the “who, what, where, when and how” clinical lactation care is offered in their state from Lactation Consultants, breastfeeding families, peer supporters, physicians and hospitals and other facilities. Stories of families that were unable to access care and/or received substandard care are very powerful. It is common for legislators to ask whether there have been incidents of harm to the public from untrained or substandard care rendered by persons who do not hold a healthcare license. You can help your state and others by sharing deidentified cases where lactation care rendered by a well-meaning, but an uninformed person, put a mother or baby in jeopardy. Please share your story or a story of someone you know by visiting

Advocating for licensure within your states will be challenging and rewarding work. Thank you for your integrity and the time this will take as you work through the legislative process. We urge you to always keep the health, safety, and welfare of breastfeeding families at the center of your work. We do!